What to Know about Infectious Diseases from ACP’s #IM2017 Conference ABIM Board Review Course

As you’ve probably noticed from our Twitter feed this week, Knowmedge chief editor Dr Sunir Kumar (@DrSunir) has been delivering real-time updates from the American College of Physicians’ Internal Medicine conference. Using #IM2017, you can view those and other relevant tweets from this year’s gathering.

Below is a compilation of 28 Infectious Disease pearls to help you with your board prep and clinical practice.

@knowmedge Rx for Listeria meningitis, Aminoglycoside with Ampicillin. If PCN allergy, Rx with TMP-SMZ. #IM2017
— Sunir Kumar (@SunirMD) March 28, 2017

@knowmedge Viral meningitis: High Lymphocytes, Glucose >40 mg/dL, Protein <300 mg/dL. #IM2017
— Sunir Kumar (@SunirMD) March 28, 2017

@knowmedge Bacterial meningitis: High Neutrophils, Glucose <40 mg/dL, Protein>100 mg/dL. #IM2017
— Sunir Kumar (@SunirMD) March 28, 2017

@knowmedge Herpes Simplex encephalitis will reveal TEMPORAL LOBE enhancement on MRI. CSF can show RBCs. Rx: IV Ayclovir. #IM2017
— Sunir Kumar (@SunirMD) March 28, 2017

@knowmedge West Nile Virus is associated with flaccid paralysis. Dx with CSF IgM antibodies. Rx–>Supportive care. #IM2017
— Sunir Kumar (@SunirMD) March 28, 2017

@knowmedge Staph aureus is the most common cause of native valve endocarditis and in IV drug users. #IM2017
— Sunir Kumar (@SunirMD) March 28, 2017

@knowmedge Valve surgery f/ IE: fungal infxn, heart failure, heart block, annular abscess, fever >5-7 days, recurrent emboli. #IM2017
— Sunir Kumar (@SunirMD) March 28, 2017

@knowmedge Diagnosis for IE can be established using the DUKE criteria. #IM2017
— Sunir Kumar (@SunirMD) March 28, 2017

@knowmedge Another indication for surgery for IE is valve vegetation >10mm. #IM2017
— Sunir Kumar (@SunirMD) March 28, 2017

@knowmedge Fourth generation combination immunoassay is used to evaluate for HIV infection. #IM2017
— Sunir Kumar (@SunirMD) March 28, 2017

@knowmedge HIV viral load or p24 antigen also used for primary HIV infection. #IM2017
— Sunir Kumar (@SunirMD) March 28, 2017

@knowmedge CD4 count< 200 increases chances of P. jiroveci. CD4 <100–> Cryptococcus and Toxoplasma. Less than 50: CMV and MAC. #IM2017
— Sunir Kumar (@SunirMD) March 28, 2017

@knowmedge Undetectable HIV viral load is < 20 copies/mL. #IM2017
— Sunir Kumar (@SunirMD) March 28, 2017

@knowmedge Usual Rx for P. Jiroveci is TMP/SMZ x3 weeks. If sulfa allergy, Rx with IV Pentamadine or IV Clindamycin + PO Primaquine. #IM2017
— Sunir Kumar (@SunirMD) March 28, 2017

@knowmedge If A-a gradient greater or equal to 35 mm Hg or PO2 < 70 mm Hg, start corticosteroids within 72 hours. #IM2017
— Sunir Kumar (@SunirMD) March 28, 2017

@knowmedge Biopsy of ring enhancing lesion recommended if Rx for Toxoplasmosis not responding to 2 weeks of therapy. #IM2017
— Sunir Kumar (@SunirMD) March 28, 2017

@knowmedge Disseminated Cryptococcus disease can lead to fungemia, pulmonary disease, or meningoencephalitis. #IM2017
— Sunir Kumar (@SunirMD) March 28, 2017

@knowmedge Oseltamivir, Zanamavir, or IV Peramivir can be used for the flu. Avoid Zanamivir in patients with underlying airway dz. #IM2017
— Sunir Kumar (@SunirMD) March 28, 2017

@knowmedge Chickenpox usually starts on trunk and spreads to face and extremities. Rash description: "dew drop on a rose petal." #IM2017
— Sunir Kumar (@SunirMD) March 28, 2017

@knowmedge Pt with sickle cell disease and osteomyelitis: think Salmonella or Staph aureus infection. Cat or dog bite: Pasteurella. #IM2017
— Sunir Kumar (@SunirMD) March 28, 2017

@knowmedge Puncture wound osteomyelitis: Pseudomonas! #IM2017
— Sunir Kumar (@SunirMD) March 28, 2017

@knowmedge Do not treat gonorrhea with Quinolones due to resistance. #IM2017
— Sunir Kumar (@SunirMD) March 28, 2017

@knowmedge Painless chancre in primary syphilis. Secondary occurs 2-8 weeks later. Tertiary: years later: Aortitis. #IM2017
— Sunir Kumar (@SunirMD) March 28, 2017

@knowmedge Neurological involvement can occur at any stage of Syphilis. #IM2017
— Sunir Kumar (@SunirMD) March 28, 2017

@knowmedge Any of these will make dx of Neurosyphilis: CSF lymphocytes > 5/uL, elevated CSF protein, or + CSF VDRL test. #IM2017
— Sunir Kumar (@SunirMD) March 28, 2017

@knowmedge Desensitize PCN allergic patients with syphilis during pregnancy, congenital syphilis, neurosyphilis. #IM2017
— Sunir Kumar (@SunirMD) March 28, 2017

@knowmedge Centor criteria for pharyngitis: Fever of 38.1, tonsillar exudates, tender anterior cervical lymphadenopathy, no cough. #IM2017
— Sunir Kumar (@SunirMD) March 28, 2017

@knowmedge BV diagnosis: thin white discharge w/o pain, discharge pH>4.5, fishy odor with KOH, clue cells. #IM2017
— Sunir Kumar (@SunirMD) March 28, 2017